Vitamin D is a vitamin and, like all vitamins, it is essential for our health and well-being. Vitamin D is mostly made in the skin by exposure to sunlight. Show
Why is vitamin D so important?Getting enough vitamin D is crucial for healthy bones and teeth. In children, being deficient in vitamin D can lead to a condition called rickets, where your bones are weak and soft and can become deformed (with bow legs). In adults, low levels of vitamin D can increase your risk of osteoporosis, or thinning of the bones. This makes you much more prone to breaking a bone. But vitamin D is important for much more than bone health. Vitamin D may play a role in:
How much vitamin D do I need?Vitamin D is sometimes known as the 'sunshine vitamin': the natural type of vitamin D is produced in your skin when you're exposed to sunlight. In the UK, sunshine isn't strong enough to allow you to make your own vitamin D in winter. So it's now recommended that everyone over 1 year old take 10 micrograms (400 International Units) a day from October to March. Certain groups of people are at higher risk of low vitamin D. It's advised that you take a vitamin D supplement of 10 micrograms (400 International Units) a day all year round if you:
In addition, your doctor may recommend that you take a supplement all year round if you have certain gut (bowel), kidney or liver diseases. Babies from birth to 1 year old should have a supplement in the form of vitamin D drops of 8.5 to 10 micrograms a day. Babies having 500 ml or more of formula milk per day do not need supplements, as formula milk already has vitamin D added. You can buy vitamin D dietary supplements at pharmacies. In the UK they are also available on prescription to certain groups of people. How to get vitamin DIf you have fair skin, around 20-30 minutes of sunlight on the face and forearms around the middle of the day 2-3 times a week is enough to make enough vitamin D in the summer months in the UK. The sunlight has to fall directly on to bare skin (through a window is not enough). If you have darker skin, you can still make some vitamin D through exposure to sunshine. However, you may not be able to make enough from sunshine and diet alone, so you should consider taking a vitamin D supplement all year round. Too much exposure to the sun's rays can be damaging. Sunburn should be avoided at all costs (mainly because it can increase your risk of skin cancer). You can also get some vitamin D from foods that either contain it naturally or have it added to them. What foods contain vitamin D?Most foods contain very little vitamin D naturally. Foods that naturally contain a source of vitamin D include:
Some foods are fortified with vitamin D (this means they have vitamin D added to them). These foods include infant formula milk, most margarines and some cereals - you can check on the packet. In some countries (but not in the UK) all milk is fortified with vitamin D. Vitamin D deficiency symptomsMany people have no vitamin D deficiency symptoms or may complain of only vague ones such as tiredness or general aches. Because symptoms of vitamin D deficiency are often very nonspecific or vague, the problem is often missed. The diagnosis is more easily reached in severe deficiencies with some of the classical (typical) symptoms and bone deformities. Many people have low levels of vitamin D but not enough to be classed as deficient in the vitamin. If your vitamin D levels are above deficient levels but still below normal, you should still top up your vitamin D even if you have no symptoms. Vitamin D deficiency symptoms in babiesBabies with severe vitamin D deficiency can get cramps (muscle spasms), fits (seizures) and breathing (respiratory) difficulties. These problems are related to consequent low levels of calcium. Vitamin D deficiency symptoms in children
Vitamin D deficiency symptoms in adults
Who gets vitamin D deficiency?Vitamin D deficiency means that there is not enough vitamin D in your body. This may be because:
You have an increased need for vitamin DGrowing children, pregnant women, and breastfeeding women need extra vitamin D because it is required for growth. So, vitamin D deficiency is more likely to develop in the following groups of people:
Your body is unable to make enough vitamin DThis can occur for various reasons:
Not enough dietary vitamin DVitamin D deficiency is more likely to occur in people who follow a strict vegetarian or vegan diet, or a non-fish-eating diet. How common is vitamin D deficiency?A lack of vitamin D is very common. One survey in the UK showed that about 1 in 5 adults and about 1 in 5 children in the UK have low vitamin D levels. More people have low vitamin D levels in the winter and spring because of less exposure to sunlight. How is vitamin D deficiency diagnosed?It may be suspected from your medical history, symptoms, or lifestyle. A simple blood test for vitamin D level can make the diagnosis. Blood tests for calcium and phosphate levels and liver function may also show changes linked to a low level of vitamin D. Sometimes a wrist X-ray is done for a child in order to see how the bones are developing. This can assess how severe the problem is by looking for changes in the wrist bones. Vitamin D deficiency treatmentThe treatment is to take vitamin D supplements. This is a form of vitamin D called ergocalciferol or calciferol. Vitamin D can be given as an injection or as a medicine (liquid or tablets). Your doctor will discuss the dose and the best treatment schedule, depending on your situation, age, severity of the deficiency, etc. Briefly, one of the following may be advised. High-dose tablets or liquidsThere are different strengths available and a dose may be taken either daily, weekly or monthly. This will depend on your situation and on which particular treatment guideline your doctor is using. Because vitamin D is a 'fat-soluble' vitamin, your body can store it, so you do not need to take it every day. This is different from water-soluble vitamins such as vitamin C, which you need to consume every day. With high doses of vitamin D it is even more important to take the medicine correctly. The advantage of the higher-dose treatment is that the deficiency improves quickly, which is very important in growing children or people who have very low levels. Standard-dose tablets, powders or liquidsThese are taken every day for about 12 months so that the body can catch up on the missing vitamin D. This is a rather slow method of replacing vitamin D, but is suitable if the deficiency is mild, or for prevention. InjectionA single small injection of vitamin D will last for about six months. This is a very effective and convenient treatment. It is useful for people who do not like taking medicines by mouth, or who are likely to forget to take their tablets. It is not widely used any more as most people prefer to take tablets. Maintenance therapy after deficiency has been treated Once vitamin D deficiency has been treated, the body's stores of vitamin D have been replenished. After this, maintenance treatment is often needed long-term, to prevent further deficiency in the future. This is because it is unlikely that any risk factor for vitamin D deficiency in the first place will have completely resolved. The dose needed for maintenance may be lower than that needed to treat the deficiency. Are there any risks to taking vitamin D supplements?Care is needed with vitamin D supplements in certain situations:
Multivitamins are not suitable for long-term high-dose treatment because the vitamin A they also contain can be harmful in large amounts. What is the outlook?The outlook (prognosis) of vitamin D deficiency is usually excellent. Both the vitamin levels and the symptoms usually respond well to treatment. However, it can take time (months) for bones to recover and for symptoms such as pain to improve. The complications of severe deficiency have been mentioned. Rickets can occur in children, and osteomalacia in adults. These diseases affect the strength and appearance of bones, and can lead to permanent bone deformities if untreated or if treatment is delayed. As well as bone and muscle health, vitamin D deficiency is associated with a number of different conditions. These conditions include diabetes, coronary heart disease, breast cancer, bowel cancer, Alzheimer's disease and many others. The exact significance of these associations isn't yet properly understood. Which of the following presents with an onset of heel pain with the first steps of the morning?Plantar fasciitis is a common cause of heel pain in adults. The disorder classically presents with pain that is particularly severe with the first few steps taken in the morning. In general, plantar fasciitis is a self-limited condition.
What areas of the body may be examined when bone densitometry is done select all that apply?The testing procedure typically measures the bone density of the bones of the spine, lower arm, and hip. Portable testing may use the radius (1 of the 2 bones of the lower arm), wrist, fingers, or heel for testing, but is not as precise as the nonportable methods because only one bone site is tested.
When providing care for a client following bronchoscopy which assessment finding should the nurse immediately report to the healthcare provider?What symptoms should I report to the doctor after bronchoscopy?. Bleeding that lasts longer that 24 hours or if it increases (report amounts greater that blood-streaked mucus).. Fever (temperature over 100F) that lasts more than 24 hours.. Shortness of breath or chest pain.. Coughing-up large amounts of blood.. |